Stress and well­being in health­care staff: the role of negative affectivity, and perceptions of job demand and discretion

A questionnaire survey was administered to volunteer staff from the Surgical and Mental Health Directorates of an English hospital district. The aim was to investigate the relationships between job stressors, coping strategies, job satisfaction and well-being, in light of Karasek's demand–discretion model. The effects of controlling for age, gender and negative affectivity were also of interest. After controlling for these factors, there was found to be no interaction between job demand and discretion for either job satisfaction or psychological distress, so Karasek's model was not supported. Both job dissatisfaction and psychological distress were found to be influenced by lack of resources, while perception of demand was strongly influenced by workload; these were also the stressors that differentiated the two hospital directorates, with the surgical staff suffering higher levels of both. Controlling for negative affectivity had a stronger influence on the measure of distress than on job satisfaction and the two outcome measures were not interchangeable. Recommendations centred on improving structural conditions, especially for surgical staff, and on reducing levels of anxiety and hostility by promoting stress management. © 1998 John Wiley & Sons, Ltd.